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[1]李前,陳紹軍,李崗,等.“8”字懸吊法重建外側(cè)副韌帶及腘腓韌帶治療膝關(guān)節(jié)多發(fā)韌帶損傷[J].中醫(yī)正骨,2017,29(03):49-51,55.
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“8”字懸吊法重建外側(cè)副韌帶及腘腓韌帶治療膝關(guān)節(jié)多發(fā)韌帶損傷()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第29卷
期數(shù):
2017年03期
頁碼:
49-51,55
欄目:
臨床報道
出版日期:
2017-03-20

文章信息/Info

作者:
李前1陳紹軍1李崗1徐昭樂1鐘佳1邵先舫1劉志軍1張晉2
1.湖南省常德市第一中醫(yī)醫(yī)院,湖南 常德 415000; 2.北京積水潭醫(yī)院,北京 100035
關(guān)鍵詞:
膝關(guān)節(jié) 關(guān)節(jié)鏡檢查 側(cè)副韌帶 腘腓韌帶 前交叉韌帶 后交叉韌帶 內(nèi)側(cè)副韌帶
摘要:
目的:觀察“8”字懸吊法重建外側(cè)副韌帶(lateral collateral ligament,LCL)及腘腓韌帶(popliteofibular ligament,PFL)治療膝關(guān)節(jié)多發(fā)韌帶損傷的臨床療效及安全性。方法:2013年1月至2015年1月,采用“8”字懸吊法重建LCL及PFL治療膝關(guān)節(jié)多發(fā)韌帶損傷患者21例,男16例、女5例。年齡18~63歲,中位數(shù)48歲。均為閉合性損傷,左膝12例、右膝9例。單純膝關(guān)節(jié)后外復(fù)合體(posterolateral corner,PLC)損傷2例,PLC損傷伴前交叉韌帶(anterior cruciate ligament,ACL)損傷3例,PLC損傷伴后交叉韌帶(posterior cruciate ligament,PCL)損傷9例,PLC損傷伴ACL及PCL損傷4例,PLC損傷伴PCL及內(nèi)側(cè)副韌帶(medial collateral ligament,MCL)損傷2例,PLC損傷伴ACL、PCL及MCL損傷1例。PLC損傷根據(jù)Fanelli分型標準,A型1例、B型2例、C型18例。受傷至手術(shù)時間16~41 d,中位數(shù)34 d。術(shù)后隨訪觀察脛骨外旋程度、膝關(guān)節(jié)外側(cè)間隙張開程度、膝關(guān)節(jié)功能恢復(fù)及并發(fā)癥發(fā)生情況。結(jié)果:所有患者均獲隨訪,隨訪時間16~38個月,中位數(shù)25個月。脛骨外旋程度,術(shù)前15.9°±4.0°、末次隨訪時-1.8°±3.3°。膝關(guān)節(jié)外側(cè)間隙張開程度,術(shù)前(12.4±2.6)mm、末次隨訪時(4.2±1.6)mm。術(shù)后3個月隨訪時,2例患者屈膝角度為90°,于麻醉狀態(tài)下行松解手術(shù)后恢復(fù)正常; 末次隨訪時,所有患者屈膝角度均>120°。國際膝關(guān)節(jié)文獻委員會評分,術(shù)前(58.1±3.7)分、末次隨訪時(88.1±1.6)分。1例伴MCL損傷患者出現(xiàn)伸膝受限約5°,2例伴PCL損傷患者出現(xiàn)膝關(guān)節(jié)后外側(cè)疼痛,1例伴MCL損傷患者出現(xiàn)MCL股骨止點異位骨化,1例伴ACL損傷患者Lachman試驗陽性伴硬性終止點,2例伴PCL損傷患者后抽屜試驗陽性伴硬性終止點。所有患者均未出現(xiàn)感染、下肢深靜脈血栓形成及膝關(guān)節(jié)錯動感。結(jié)論:“8”字懸吊法重建LCL及PFL治療膝關(guān)節(jié)多發(fā)韌帶損傷,能夠降低脛骨外旋程度及膝關(guān)節(jié)外側(cè)間隙張開程度,促進膝關(guān)節(jié)功能恢復(fù),且安全性較高,值得臨床推廣應(yīng)用。

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通訊作者:張晉 E-mail:[email protected]
更新日期/Last Update: 1900-01-01